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General NPI Number Information
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NPI Number | 1447724620
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Entity Type | Organization
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Legal Business Name | ELITE MOVEMENT CHIROPRACTIC CLINIC PLC
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Dates
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Enumeration Date | 01/22/2019
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Last Update Date | 03/19/2019
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Provider Practice Location Address
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Address Line | 2810 CHARLEVOIX RD STE 101
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City | PETOSKEY
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State | MI
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Zip | 49770-8421
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Country | US
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Telephone | 231-881-9280
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Fax | 231-881-9288
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Provider Business Mailing Address
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Address Line | 2810 CHARLEVOIX RD STE 101
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City | PETOSKEY
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State | MI
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Zip | 49770-8421
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Country | US
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Telephone | 231-881-9280
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Fax | 231-881-9288
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Authorized Official
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Title or Position | CHIROPRACTIC PHYSICIAN
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Name | DR. GARRETT JOHN-OTTO KUHLMAN
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Credential | DC, CCSP
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Telephone | 517-442-8757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NS0005X
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Taxonomy Name | Sports Physician Chiropractor
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License Number |
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License Number State |
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